NRSG529 - Comprehensive Care for Older Persons

Year

Credit points

Campus offering

Prerequisites

NRSG524 Advanced Pathophysiology for Specialty Nursing Practice AND NRSG525 Evidence-based, Person-centred Family Care in Specialty Nursing Practice

Unit rationale, description and aim

Ageing populations and increased life expectancies are associated with an increased burden of disease, increased frailty and increased degrees of functional decline that demands significant consideration to be given to providing a multi-faceted approach to care. Older persons have the right to be able to access long term support and care in settings where they are treated with respect and dignity, and where care is individually designed to cater for their preferences, diversity and complexity. It is critical that gerontological nurses understand the systems of governance and quality improvement processes that are used in gerontological settings to drive high quality and safe care for older persons.

This unit is required by students because the complexity of care required by older persons now demands gerontological nurses have depth of analytical, cognitive and advanced problem solving skills to effectively and efficiently analyse the care requirements for older persons as they transition through to end of life care.

The effects of life transitions on older persons such as retirement, changes in health conditions, social and personal loss, and a loss of autonomy can be significant. Older persons are also susceptible to physical and emotional harms, and a loss of mobility and cognitive capacity. It is critical that gerontological nurses are equipped with the specialist knowledge and skills to effectively advocate and guide and care for older persons through these transition stages using evidence-based, ethical practice. Selection of content is based on the complexity of care required by older persons and the recent advances in gerontology and gerontological nursing. Key concepts of patient’s rights, governance frameworks, continuous improvement systems, loss and grief, elder abuse and behaviours and perceptions of older persons will be explored to assist students with skills in analysis, evaluation, and application of informed decision-making to ensure inclusive, respectful, person-centred care in the gerontological setting.

The aim of this unit is for students to critically appraise, evaluate and demonstrate knowledge and skills required for delivery of complex, diverse, inclusive and ethically based care for older persons within governance frameworks and organisational systems, to ensure older persons are treated with dignity and respect.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Examine the transitions of life and evaluate the impacts these factors have on the older persons’ dignity and quality of life (GA4, GA5, GA6, GA8, GA9)

LO2 - Determine the factors that contribute to elder abuse, analyse the effects they have on older persons’ quality of life and evaluate the range of strategies that can be implemented to negate this risk (GA1, GA2, GA3, GA4, GA5, GA6, GA8)

LO3 - Analyse governance frameworks and continuous improvement systems used in gerontological settings, while critically reflecting upon the role of the nurse in relation to continuous quality improvement (GA1, GA2, GA3, GA5, GA7)

LO4 - Using a culturally sensitive approach, analyse the specific care needs that are present for older persons and apply this knowledge to inform evidence-based, ethical, family-centred care in gerontological settings (GA1, GA2, GA3, GA4, GA5, GA10)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity

GA2 - recognise their responsibility to the common good, the environment and society

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media 

GA10 - utilise information and communication and other relevant technologies effectively.

Content

Topics will include:

Understanding Behaviours and Perceptions of Older Persons

• Therapeutic communication with older persons
• Expectations
• Judgement
• Labels
• Societal and cultural norms
• Improving self-identity
• Minimising vulnerability
• Care negotiations

Care delivery to older persons

• Comorbidity and complex care
• ACFI
• Consent advocacy

Continuous Improvement Systems

• Aged Care Quality Standards Reporting
• Restrictive practices
• Serious Incident Response Scheme
• Mandatory Quality Indicator Program
• Antimicrobial Stewardship in Community and Aged Care

Elder Abuse

• Rights, responsibilities and risks in Aged Care Settings
• Assessment
• Aggression
• Threatened rights
• Restraint
• Role of the nurse

Continence

• Types
• Risk factors
• Impacts
• Promotion

Loss and Grief

• Transition of settings
• Facilitating adjustment
• Empowering older persons
• Ensuring dignity and respect

Intimacy and Sexuality

• Effects of ageism on sexuality
• Sexual health and well being
• Ageing and LGBTI older persons

Palliative Care

• Dignity
• Quality of life
• Advanced care planning
• End of Life Care
• Voluntary Assisted Dying Legislation
• Bereavement

Learning and teaching strategy and rationale

This unit is offered in online mode and uses an active and collaborative learning approach to support students to analyse and critically evaluate the stages of the ageing process in relation to governance frameworks, continuous quality improvement systems, physiological considerations and end of life care within gerontological nursing settings. Students will engage in readings and reflections, e-Learning activities and opportunities to collaborate with peers in an online environment. This can involve, but is not limited to, online discussion forums, chat rooms, guided reading and webinar sessions. In addition, e-Learning and links to electronic readings will be provided to guide students’ reading and extend other aspects of online learning. 

Through an online learning platform, students will have the opportunity to reflect on nursing care that is guided by systems, processes and ethical perspectives to inform high quality, safe, diverse and individualised older person care delivery. Online learning in this unit will be supported by the provision of opportunities for students to attend online webinar sessions that allow synchronous exchange of information and facilitate responses to queries generated by students in relation to unit content. For those unable to participate in synchronous webinar sessions, recordings will be available.

Students are required to complete online activities and assessments to demonstrate the application of knowledge. The learning and teaching strategy used in this unit allows flexibility for students while ensuring they have expert support. These modes of delivery assist students in linking knowledge and skills to the gerontological nursing context, and to develop shared meanings through online experiential reflections and discussions.

Assessment strategy and rationale

In order to successfully complete this unit, a minimum combined total grade of all assessment tasks of 50% is required to pass this unit.

The assessment strategy used in this unit encourages depth of learning and provides the students the opportunity to develop their capacity to interpret, translate, apply and evaluate evidence-based care provision in gerontological settings. In order to develop gerontological nursing knowledge and skills required to achieve the learning outcomes and Graduate Attributes, students apply learned knowledge and demonstrate critical thinking skills, analysis and synthesis of evidence in relation to the rights and responsibilities for older persons in gerontological settings and explore how governance frameworks and standards are implemented to mitigate risk. Students then create an e-Poster on altered behaviour in gerontological settings. Students are expected to work collaboratively on the second assessment which requires peer feedback participation.

Overview of assessments

Representative texts and references

Arnold, E., & Boggs, K. U. (2019). Interpersonal relationships: professional communication skills for nurses (8th ed.). Saunders. https://www-clinicalkey-com-au.ezproxy2.acu.edu.au/nursing/#!/browse/book/3-s2.0-C20160046107

Bryant, B., & Knights, K. (2019). Pharmacology for health professionals (5th ed.). Elsevier. https://www-clinicalkey-com-au.ezproxy2.acu.edu.au/nursing/#!/browse/book/3-s2.0-C20170006882

Estes, M. E. Z., Calleja, P., Theobald, K., & Harvey, T. (2016). Health assessment and physical examination (Australian and New Zealand 2nd edition.). Cengage Learning Australia. https://ebookcentral.proquest.com/lib/acu/detail.action?docID=1990989

Hoffmann, T., Bennett, S., & Del Mar, C. (2017). Evidence-based practice across the health professions (3rd ed.). Elsevier. https://www-clinicalkey-com-au.ezproxy1.acu.edu.au/nursing/#!/browse/book/3-s2.0-C20160032369

Jackson, S. L. (2018). Understanding elder abuse : a clinician’s guide (First edition.). American Psychological Association. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/qpf7hm/alma991012873951202352

Johnson, A., & Chang, E. (2017). Caring for Older People in Australia. Principles for nursing practice (2nd Ed). Wiley. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/13lm7d8/alma991012703299302352

Matzo, M., & Sherman, D. (Eds.). (2019). Palliative care nursing: Quality care to the end of life (4th ed.). Springer. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/13lm7d8/alma991012953299002352

Miller, C. A. (2019). Nursing for wellness in older adults (Eighth edition.). Wolters Kluwer. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/13lm7d8/alma991012790754402352

Taylor, K. (2019). Health care and Indigenous Australians: cultural safety in practice (3rd ed.). Macmillan International Higher Education: Red Globe Press. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/qpf7hm/alma991012985599202352

Vafeas, C., & Slatyer, S. (2021). Gerontological nursing : a holistic approach to the care of older people. Elsevier. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/qpf7hm/alma991013098292902352